MRCP与ERCP诊断慢性胰腺炎的对比研究

COMPARISON OF MRCP AND ERCP IN DIAGNOSIS OF CHRONIC PANCREATITIS

为评价磁共振胆管造影 (MRCP)和ERCP在慢性胰腺炎诊断中的价值 ,回顾分析 1993年 1月～ 2 0 0 1年 12月长海医院收治的具有临床表现、影像学及病理检查确诊的慢性胰腺炎 2 6 2例 ,其中同时行MRCP和ERCP检查 12 0例。 12 0例慢性胰腺炎病人中 ,经MRCP发现胰、胆管狭窄、扩张、结石等病变并诊断为慢性胰腺炎 10 6例 ,准确率为 88 3% ;经ERCP检查发现胰、胆管病变并确诊为慢性胰腺炎 10 8例 ,准确率为 90 % ,统计分析两者无显著性差异(P =0 6 78)。MRCP和ERCP同时提示胰、胆管病变并确诊为慢性胰腺炎 96例 ,诊断符合率为 81 4 % ;MRCP与ERCP相结合诊断慢性胰腺炎 118例 ,诊断准确率为 98 3%。MRCP和ERCP造影成功率均为10 0 % ,未发生严重的并发症。上述结果提示 ,MRCP和ERCP在诊断慢性胰腺炎中有很好相关性 ,两种诊断方法之间统计分析无显著性差异 ,两种检查方法相结合则可显著提高慢性胰腺炎的诊断准确率。

The aim of this study was to evaluate the diagnostic value of MRCP and ERCP in patients with chronic pancreatitis. A total of 262 patients were diagnosed as charonic pancreatitis by clinical feature, screenage and pathology from January 1993 to December 2001 in Changhai Hospital. Among them 120 patients who had been subjected to MRCP and ERCP were analyzed retrospectively. There were 106 patients discovered constriction, dilatation and calculuses of pancreatic, bile ducts, and diagnosed chronic pancreatitis by MRCP, the sensitivity was 88 3%. Also there were 108 patients discovered cholangiopancreatic disorder and diagnosed chronic pancreatitis by ERCP, the sensitivity was 90%. No statistical difference was found between interpretations based upon MRCP and ERCP( P =0 678). Results from both MRCP and ERCP discovered 96 patients with chronic pancreatitis; the agreement rate in diagnosis was 81 4%. Furthermore, 118 patients were diagnosed chronic pancreaitis by MRCP or ERCP, and the sensitivity was up to 98 3%. In addition, all examined patients were succeeded and no severe complications were found in regard to examination itself. So MRCP is as sensitive as ERCP when detecting chronic pancreatitis. Furthermore, it is feasible to presume that all chronic pancreatitis cases could be diagnosed by MRCP combined with ERCP.